If you live with fibromyalgia, you may already be familiar with widespread muscle pain, fatigue, poor sleep, and the frustrating feeling that your body seems to hurt in places you never expected.
But what about pelvic pain?
Many of the patients we see at our clinic who suffer with fibromyalgia also experience pelvic health symptoms such as pelvic pain, urinary urgency or leakage, constipation, painful intercourse, pelvic pressure, or difficulty relaxing the pelvic floor.
Understanding how fibromyalgia and pelvic health can overlap may help you better understand your symptoms and, most importantly, know that pelvic floor physical therapy may be part of your care team.
What Is Fibromyalgia?
Fibromyalgia is a chronic condition characterized by widespread pain and increased sensitivity to pain. People with fibromyalgia may also experience fatigue, sleep difficulties, stiffness, headaches, difficulty concentrating, and other symptoms.
One important part of fibromyalgia is the way the nervous system processes pain.
In simple terms, the nervous system can become more sensitive to signals coming from the body. This is sometimes described as increased pain sensitivity or altered pain processing.
But, that doesn't mean the pain isn't real. It's actually the opposite!
The pain is real and the way the brain and nervous system interpret and respond to signals can contribute to how intense, widespread, or persistent the pain feels.
Fibromyalgia is different for everyone, and symptoms can fluctuate over time. Stress, poor sleep, illness, physical activity, and other factors may influence symptom severity.
What Does Fibromyalgia Have to Do With the Pelvic Floor?
The pelvic floor is a group of muscles that sits at the bottom of the pelvis. These muscles help support the pelvic organs and play an important role in bladder and bowel control, sexual function, pelvic stability, and pressure management.
Like any other group of muscles, the pelvic floor can become:
- Weak
- Tight or overactive
- Painful
- Difficult to coordinate
- Sensitive to touch or pressure
For someone living with fibromyalgia, the pelvic floor may be affected by the same broader changes in pain sensitivity and muscle tension that occur elsewhere in the body.
Research has found that women with fibromyalgia report pelvic floor symptoms more frequently than women without fibromyalgia, including urinary and bowel symptoms, pelvic pain, and sexual dysfunction.
This doesn't mean that everyone with fibromyalgia will develop pelvic floor dysfunction. It just means that if you are experiencing pelvic floor symptoms along with fibromyalgia, it is worth mentioning to your pelvic floor pt.
What Does Fibromyalgia-Related Pelvic Pain Feel Like?
There isn't one specific type of pelvic pain associated with fibromyalgia.
Depending on the person, symptoms may include:
- Aching or pressure in the pelvis
- Pain around the vaginal or rectal area
- Tailbone pain
- Pain with sitting
- Pain with intercourse or penetration
- Pelvic floor muscle tenderness
- Pain with bowel movements
- Urinary urgency or frequency
- Burning or uncomfortable bladder sensations
- Difficulty relaxing the pelvic floor
- Constipation or difficulty emptying the bowels
- Pain that seems to move or fluctuate
- Increased sensitivity to touch or pressure
Some people may also experience pain outside the pelvis at the same time, such as low back, hip, abdominal, or generalized muscle pain.
This is one reason we don't look at pelvic pain in isolation.
Why Can Pelvic Pain Feel So Intense With Fibromyalgia?
This is where understanding the nervous system becomes important.
Your body has an incredibly complex system for detecting and responding to sensations. When pain has been present for a long time, the nervous system can become more protective and more sensitive.
For someone with fibromyalgia, this increased sensitivity can occur throughout the body. When pelvic floor muscle tension or another pelvic health issue is added to the picture, symptoms can become even more disruptive.
Research involving people with chronic pelvic pain has also found an association between greater features of widespread or nociplastic pain and greater pelvic pain severity and impact.
This is one reason we don't want to simply treat the painful area.
We want to understand why your body is experiencing the pain in the first place.
How Can Pelvic Floor Physical Therapy Help?
Pelvic floor physical therapy for someone with fibromyalgia may look different from traditional strengthening-focused pelvic floor therapy.
Our goal isn't automatically to make the pelvic floor stronger.
Sometimes the first goal is helping the pelvic floor learn how to relax.
If you have fibromyalgia and are experiencing pelvic symptoms that are affecting your daily life, it may be worth seeking a pelvic floor evaluation.
Call/Text us at (908) 777-0090 to schedule a pelvic floor evaluation.
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